A second opinion

Yesterday I met Dr Georgiana Ellis, a hematologist / oncologist at Seattle Cancer Care Alliance who Dr G highly respects. She reviewed my history and made some recommendations for future treatment. I don't know yet what Dr G will think is best, but it was very interesting to get another perspective on my situation.

From my notes:

- Liver mets tend to grow faster than bone mets, so the first step should be to get them under control with chemo, then look to an anti-hormonal drug for maintenance.

- Repeat CT and bone scans to get the most up to date information on the cancer's activity. Consider a brain MRI to see if cancer might cause the vertigo I've experienced recently.

- Test tumor markers CA 27.29 and CEA.

- There are no clinical trials open now for which I'd be a candidate.

- Consider low dose Xeloda (oral chemotherapy), two weeks on and one week off, perhaps in combination with Navelbine. At a lower dose of Xeloda, Dr Ellis doesn't think I will be bothered too much by hand-foot syndrome (which was the original reason I didn't want to try Xeloda last year). In her experience, her patients with lymphedema do not report hand-foot syndrome negatively affecting their edema.

- If we choose to stay with high dose Faslodex now, Dr Ellis recommends careful monitoring to be sure my disease remains under control.

- Regarding estrogen therapy, Dr Ellis has used a lower dose of 2 mg three times a day, which had fewer complications and the same efficacy as higher dose estrogen.

I learned a lot from Dr Ellis and imagine that Dr G will share his recommendations with me the next time I see him, in a few weeks.